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VANTAGE POINT

News . Views . Reviews

Wellness features in health insurance make sense

Insurance companies have started offering additional benefits with their policies. Cigna TTK Health Insurance recently launched a ProHealth Plan that helps individuals deal with problems such as stress, overweight, smoking and irregular sleeping.

It also offers an optional ‘health coach’ programme for those with pre-existing diabetes and hypertension. A qualified dietician sets goals for the insured, such as keeping sugar levels in check, weight loss and maintaining blood pressure. “On achieving each goal, an individual accumulates points that can be used to reduce premiums or enroll in other health-related programme,” says Jyoti Punja, chief distribution officer.

Similarly, Apollo Munich Health Insurance offers an Optima Restore plan, wherein policyholders can get many benefits, such as customised diet and exercise plan and online health assessment. Bajaj Allianz General Insurance has tied up with about 40 service providers to provide a chat with doctor, chat with specialists for second opinion, personalised diet charts and discounts on gym membership with all its health products, according to Abhijeet Ghosh, head — health administration team.

“Insurance companies have been looking at different ways to reduce risks in their portfolios, as the insurance regulator no longer allows them to terminate a policy mid-way. They are introducing wellness and disease management features to ensure that their policyholders are healthy and claims reduce in the long term,” says Ramani Vaidyanathan, vice-president — health insurance at Policybazaar.com.

In fact, after the regulation change, insurance companies have been very cautious of individuals with pre-existing chronic diseases, and it’s very difficult for such patients to get a regular health insurance. Some insurers have started launching plans exclusively for such individuals and incentivise them to keep their disease in check.

Companies offering wellness and disease management have also kept their premiums competitive. For a 40-year-old man opting for a Rs 5 lakh cover, the premium for Apollo Munich’s Optima Restore comes to Rs 8,415. The same cover from other insurers, which don’t offer a wellness programme, ranges between Rs 7,800 and Rs 8,400. Cigna TTK, on the other hand, charges a premium of Rs 7,924 for a 40-year-old opting for Rs 5.5 lakh insurance under ProHealth Protect Plan. If someone with the same profile has diabetes, he will need to shell out Rs 9,112 for premiums.

It’s worth opting for an insurance cover from someone offering disease management for a pre-existing ailment. “If you go for disease management on your own, it can cost around Rs 7,000-Rs 8,000 for a three months. These companies offer it at no extra cost. In addition, if a person maintains good health, he also gets discount on premium for the next year,” says Mahavir Chopra, director health, life and strategic initiatives at Coverfox.com

Experts say before opting for a plan with wellness benefits or disease management, do go through the features on offer. Opt for them only if there’s real benefit. Many insurers only provide a discount and nothing more. Don’t fall for such gimmicks.

Source: Business Standard

For diabetes, insurers are becoming risk managers too

May 26, 2016

On April 7, earmarked as World Health Day, the World Health Organization (WHO) focused on the theme ‘Prevent. Treat. Beat Diabetes’, highlighting the importance of fighting the global epidemic. The first WHO global report on diabetes stated that the number of adults living with diabetes has almost quadrupled to 422 million in 2014 from 180 million in 1980. While China has the largest number of cases, India has moved to the second spot with 69.1 million people living with this health issue.

Our internal analysis of health insurance claims shows that claims with diabetes hovered around 20% during 2012-15. In a clear case of concern, claims with diabetes in the age group of 26–45 years contributed to 20–22% of the claims.

Uncontrolled diabetes increases the risk of ailments affecting multiple organs. Delay in detection and control of ailments as well as conditions such as hypertension, can lead to co-morbidity, which can aggravate other life threatening critical diseases. Adults with diabetes have a 2-3 fold increased risk of heart attacks and strokes. The overall risk of premature death among people with diabetes is at least double the risk of their non-diabetic counterparts.

Due to its chronic nature and the severity of complications, diabetes is a costly disease. Studies in India estimate that for a low-income Indian family with an adult diabetes patient, as much as 25% of the family income may be devoted to diabetes care. Apart from the financial burden, it curtails one’s ability to work effectively. Intangible costs (pain, anxiety, inconvenience and generally lower quality of life) also impact the lives of patients and their families.

But diabetes can be prevented or the complications can be delayed through daily exercise and healthy diet. Early diagnosis through regular blood sugar testing and timely intervention in terms of blood glucose control can enable one to live well, even if diagnosed with diabetes. In countries such as the UK and China, governments and their agencies are working towards preventing diabetes and reducing its consequences by creating a weight control programme. The approach involves multiple elements, including creating awareness about a healthy lifestyle, working with food industry towards making healthier foods, screening for diabetes and providing counselling on diet, exercise and medications, and patient management.

In India, policymakers are working towards diabetes control by introducing interventions as well as focusing on awareness and behavioural changes by promoting screening and early diagnosis of people with high risk followed by treatment. The recent discussions pertaining to imposing a cess on sugar sweetened beverages is in line with the WHO recommendation to governments to levy taxes on sugar-sweetened beverages to reduce childhood obesity. Several countries, including the US, France, Hungary, Mexico and Finland, have already taken measures on this front and early indicators point to the desired behavioural change in terms of consumption.

For India, it makes sense to take faster steps in this direction, considering that the annual per capita consumption of sugar sweetened beverages has increased significantly from 2 litres a person to 11 litres a person between 1998 and 2014. Further, there are added benefits to this in terms of water conservation when production of such beverages is brought down.

Insurance companies, too, are taking multiple initiatives to reduce incidence rates. Insurers are moving beyond their role of being risk financers to become risk managers by offering wellness solutions covering diet and nutrition consultation, fitness therapy and more. Insurers are also introducing indemnity-based outpatient department (OPD) products that enable customers to avail insurance benefits for consultation, diagnosis as well as pharmacy. These initiatives should motivate customers to become more responsive towards maintaining their health.

While diverse stakeholders work towards addressing the diabetes issue, it is ultimately in the hands of each one of us to take charge of our health. No incentive or penalty can substitute one’s resolve to lead a healthy life. Further, as medical treatments become expensive, it is important to stay protected against financial impact of medical expenses by availing of a comprehensive health insurance policy at an early age. As a society, we need to collaborate and ensure that we successfully prevent, treat and beat diabetes.

Source: LiveMint.com

Revised IPO guidelines soon for insurance firms: IRDAI

May 23, 2016

Revised IPO guidelines will be issued soon for insurers as some of them are keep to tap this route, regulator IRDAI Chairman T S Vijayan said today while pegging the total foreign investment in sector at Rs 15,000 crore in the last one year due to increase in FDI limit.

Vijayan said the total investment of of more than Rs 15,000 crore has come to India in various forms -- mostly equity -- since the passage of the Insurance Laws (Amendment) Bill last year.

The bill, passed in March 2015, raised the foreign investment cap in the sector from 26 per cent to 49 per cent.

Addressing a press conference here, Vijayan said there may be some more investments in the pipeline.

On the insurance sector business last fiscal, Vijayan said there was 12 per cent growth in life insurance and 14 per cent growth in non-life insurance, while the health insurance sector grew by 40 per cent.

"Business has been good for all insurance companies in April. If this trend continues, we can expect higher growth in financial year 2016-17 also in life, non-life and health," he aded.

Vijayan said health insurance penetration is very low in India and there is potential for higher growth.

On regulations for IPOs by insurance companies, he said the Insurance Regulatory and Development Authority of India (IRDAI) may bring in some changes in the guidelines for the companies wanting to dilute equity.

"I am not very sure. I think there are one or two companies wanting to go for IPO. I do not know whether they have applied for clearance I do not know," Vijayan said when asked about the names of the companies that are planning to go for equity dilution.

"We started working on some changes in the existing norms for IPO. In a month or so we will come out with those norms," he explained.

HDFC Standard Life recently announced plans to launch its Initial Public Offer (IPO) wherein parent HDFC Ltd would sell 10 per cent stake. Besides, ICICI Prudential also plans to launch an IPO.

Meanwhile, Insurance Information Bureau of India said it is hosting 'IIRFA-2016', the Annual Conclave of Insurance Information and Ratemaking Forum of Asia here on May 26-27.

R Raghavan, CEO of IIB said IIRFA is a pan-Asian body of Insurance analytics and rate-making bodies and its annual conclave is held in a different member country each year. This year, it is being held in India, hosted by IIB.

Source: The Economic Times

Insurance ombudsman upping its act, disposes 92% cases in 2015-16

May 19, 2016

The Insurance Ombudsman of India has seen more success in disposing the grievances of the public when it comes to non-settlement of insurance claims, with the quasi-judicial body seeing a 92% clearance of cases as compared to 78% the previous year.

The drive to increase awareness — at its 17 centres in India — has picked up with faster disposal, larger settlements and no backlogs, said the insurance ombudsman's office, which handles claims in personal lines of life, motor, health, housing and personal accident insurance. The Tamil Nadu and Pondicherry office, in particular, has seen a 100% settlement of cases in last two years with 1,170 cases being disposed for the 2015-16 fiscal and 1,527 cases for 2014-15.

Outgoing Insurance Ombudsman, Chennai, Virander Kumar said that his office has awarded settlements for 972 cases amounting to about 507.61 lakh in the last three years. Decisions were overwhelmingly in favour of policyholders with ruling in 69% cases in favour of complainants and only 31% in favour of the insurance company.

Kumar said that in life insurance they were seeing a majority of complaints from mis-selling or over-representation of the benefits of a policy. "We had a case of a fraudulent broker in the city . We were constantly receiving complaints , but we were able to bring them to book only after we got hold of a single receipt for 3 lakh, when they actually had sold two policies from two different insurers for 1.5 lakh each . Another deviation was that they sold it via an agent's license instead of using their own broker license - and such things can happen only with the connivance of insurance companies. We brought it to the attention of the IRDA and we awarded relief for 35 of the 40 cases brought to us," Kumar added.

When it came to time taken for claims disposal the insurance ombudsman was able to review 87% cases within three months for 2014-15. Only 13% of cases took over three months for disposal. When it came to the number of complaints, life insurance sector saw a higher number of cases being registered. For 2014-15, as many as 995 life insurance complaints were disposed off versus 532 general insurance complaints.

In most cases, the insurance ombudsman was successful in convincing both parties to settle; with 902 cases being withdrawn or settled of 995 life insurance cases in total for 2014-15. Only for 93 cases did the ombudsman give awards. In general insurance also a majority of 333 cases were settled or withdrawn and 199 received awards.

The Insurance Ombudsman has been created to settle cases out of courts, so that policyholders have their grievances addressed in a timely and efficient manner and by experts without hiring lawyers and running into expenses. The quasi-judicial body is under the purview of the Governing Body of Insurance Council (GBIC), established under Redressal of Public Grievances Rules 1998.

The Board of Directors of United India Insurance Company Limited has approved the Company’s accounts for the year 2015 – 16 on 13th May 2015. The Company completed a premium of '12250 Crores for the year growing at over 14.58%. The Company posted this creditable business growth despite acute competition in the market among the 29 players. The Company’s growth trajectory was fuelled by health insurance growing at 30%, motor at over 13.42% and fire insurance at over 5%. Personal Accident portfolio and Liability portfolio have posted growth of 10% and 17% respectively.

Various Verticals of the Company have performed and shown high growth during the year. The LCB vertical, despite stiff competition grew by 16%. The SME vertical grew by 26% during the period to reach '473 Crores.

The bancassurance vertical also made big strides growing at 20.63% during the year, with a robust 45 bancassurance partners spread across major public sector, rural and cooperative banks across the country procuring a premium of '643 Crores.
The agency vertical grew by 14% in the year, with an accretion of ` 743 Crores The company has 54536 agents and plans to take the agency strength to 60000 in the current year.

Under Pradhan Mantri Suraksha Bima Yojana, where Personal Accident cover of '2 lacs is available to bank account holders at '12/- per annum, the Company has already enrolled more than 2.28 crore customers, under the scheme. As on date 1425 claims have been reported, out of which 1180 claims have been settled. The Company has taken various initiatives to obtain renewals in respect of all the enrolments. We have carried out an advertisement campaign through ‘Radio City’ Channel in different languages in the month of April 2016, sent SMS alerts to the enrolled insureds and communicated to our Bancassurance partners. The advertisement campaign is going to be repeated during the month of May 2016 in order to ensure renewal of the policies.

The net incurred claims were impacted due to the unprecedented catastrophic floods in Chennai, the like of which was not seen in the last hundred years. The Company received 7480 claims amounting to '1413 Crores More than 98% of these claims have been settled. The Chennai

Regional Office of the Company had carried out a commendable job by carving out a separate cell to deal with the claims that were reported during the month of December 2016. The Company offered on-the spot compensation based on the make of the vehicles which was well received by the insureds. Seven Camps were organized to receive claim intimations during the disaster period. Despite this, the Company, through efficient claims management, was able to post claims ratio of 87.81% which is a nominal increase of 3.39% compared to last year.

The Company has reported a Profit Before Tax of '256 Crores and Profit after Tax (PAT) of
'221 Crores The Investment income of the Company for the year stood at '2472 Crores as against '2126 Crores in the previous year, an increase of over 16%. The Market value of the Company’s total investment portfolio at the end of the year was '24021 Crores and the Networth of the Company stood at a robust '5731 Crores as against '5589 Crores at the end of the last year.

MSME sector is projected as the growth driver of the Indian economy. Similarly, rural economy will have an enhanced role in the economic growth trajectory of the country. In view of this, the Company would continue its thrust on the retail, MSME and rural insurance segments. The Company is launching a unique product targeting the MSME sector under the brand name “UNI MSME Protect” which is a package policy covering, Fire material damage, Burglary, Public Liability and Money Insurance.

The Company is efficiently managing the mammoth TN Chief Minister’s Health Insurance Scheme for BPL families. The Company is also implementing the TN Government Pensioners Health Insurance Scheme covering more than 6 lakh pensioners.

The Company has recruited 1050 employees last year to service the growing business and customer needs. The Company has advertised to recruit 300 officers this year. The Company has rolled out CORE insurance solution across all offices and all LoBs.

The Company introduced two new products in the market last year UNI Product Liability, UNI Executive Protect Insurance and a revised ShopKeepers Insurance Product.

The Company plans to launch initiatives to further the insurance inclusion in the country by opening more Micro Offices in tier 4 towns and below during the year. Last year 83 micro offices were opened taking the total of such offices to 967. The Company has also mapped around 8456 Rural Authorized Persons under the Common Service Centre Distribution Channel. The Company would tie up with more Insurance Marketing Firms and introduce products to be sold through the Points of Sales Persons, the new distribution channels approved by the Authority.

The company adopted a Corporate Social Responsibility (CSR) programme in terms of adopting villages to improve their social and educational infrastructure and spreading insurance awareness amongst students in the identified schools. Last year the company adopted 10 villages and plans to adopt 25 villages under Rural Infrastructure Program. The Company has plans to adopt 6 villages during the current fiscal with a Comprehensive Village Adoption Scheme. Last year insurance awareness was spread in 53 identified schools and in current year the company plans to do the same in 50 schools. The company donated '2 Crores to TN Chief Minister’s Relief Fund last year apart from participating in the relief work by distributing water bottles, blankets etc.

The Company has online customer portals in respect of 8 retail insurance products (Motor, Health, PA, OMP, House holders, Shopkeeper, Crop insurance and Marine Insurance Open cover) and extended online portal facilities to 2032 motor dealers and 11906 agents. More than 39 lakh policies were issued through the portals. The Company has a secure mobile insurance application to facilitate easy access anytime – anywhere for buying insurance by the customers.

The visibility of the Company has grown immensely thanks to the various accolades and awards conferred on it over the years, with the India Insurance Awards for
a. “Bancassurance Market Leader – General Insurance and Undeserved Market Penetration-General Insurance”,

b. ASSOCHAM “Corporate Governance Excellence” Awards.

c. Our Corporate Calendar with the theme “ MAKE IN INDIA”, was awarded the first position in the PRSI-Make In India Award – Best Innovation to Promote Make In India – against All India Competition from various parts of the Country.

f. Official Language implementation Committee, Chennai, – First position among Public Sector undertaking for progressive use of Official language

g. “ Lions CSR Award ”- The international Association of Lions Club

The Company proposes to build a 15 storey structure in the existing land which will become a landmark in the Chennai City. The foundation stone of the new building was laid on 12.05.2016 during a pompous ceremony organized in the premises.

The Company continues to enjoy strong fundamentals with a Solvency Ratio of 1.91 as against the Regulatory requirement of 1.50. ICRA has accorded iAAA rating for the 13th successive year to the Company, indicating its highest claim paying credentials. The Company secured a financial strength rating of B++ (Positive), for the last four years from AM Best, an International Rating Agency. The year’s results show that the Company’s strategies are yielding the desired results and the Company is optimistic to comfortably complete a premium of '14,444 Crores with over 17% growth rate in the current fiscal.

The Company has 16366 experienced and talented human resources who are passionately working to take the Company to greater heights and also promote the cause of insurance inclusion of the vast uninsured population in the country.

We are grateful to the millions of customers across the country for their continued patronage to our Company.

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